Lokal ileri evre skuamöz hücreli baş ve boyun kanserinde sisplatinle eş zamanlı kemoradyoterapi: Yan etki ve uygulanabilirlik analizi

Beste Melek Atasoy; Faysal Dane; Murat Sarı; Züleyha Akgün; Perran Fulden Yumuk; Nazım Serdar Turhal; Ufuk Abacıoğlu; Meriç Şengöz

Cisplatin-based concomitant chemoradiotherapy in locally advanced squamous cell carcinoma of head and neck: Toxicity and feasibility analysis

Year 2008, Volume: 23 Issue: 1, 1 - 11, 01.02.2008

Beste Melek Atasoy Faysal Dane Murat Sarı Züleyha Akgün Perran Fulden Yumuk Nazım Serdar Turhal Ufuk Abacıoğlu Meriç Şengöz

Abstract

OBJECTIVES In this study, we assessed the side effects and the factors related to patients, disease and, treatment that might change the decision for concurrent chemoradiotherapy (CRT) in locally advanced head and neck cancer. METHODS A total of 65 patients (49 primary; 16 postoperative) who received curative radiotherapy (median 70 Gy) with conventional fractionation schedule were enrolled into the study. Concomitant cisplatin were administered either 60-80 mg/m2 every 3 weeks (n=57) or 40 mg/m2 weekly (n=8). RESULTS Concurrent chemotherapy was completed in 46.1% patients. Premature chemotherapy termination was done due to grade 3 adverse event (41.6%), patients' refusal (19.4%) or physician decision (33.3%). Initial Karnofsky Performance Status (KPS) significantly predicted concurrent chemotherapy completeness (KPS ≥90, 63.8% vs KPS

Keywords

Carcinoma, Squamous Cell, Head and Neck Neoplasms, Radiotherapy, Chemotherapy, Adjuvant, Combined Modality Therapy, Adverse effects, Cisplatin, Feasibility Studies

References

1. Fu KK, Pajak TF, Trotti A, Jones CU, Spencer SA, Phillips TL, et al. A Radiation Therapy Oncology Group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: first report of RTOG 9003. Int J Radiat Oncol Biol Phys 2000;48(1):7-16.
2. Browman GP, Hodson DI, Mackenzie RJ, Bestic N, Zuraw L; Cancer Care Ontario Practice Guideline Initiative Head and Neck Cancer Disease Site Group. Choosing a concomitant chemotherapy and radiotherapy regimen for squamous cell head and neck cancer: A systematic review of the published literature with subgroup analysis. Head Neck 2001;23(7):579-89.
3. Bourhis J, Overgaard J, Audry H, Ang KK, Saunders M, Bernier J, et al. Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis. Lancet 2006;368(9538):843-54.
4. Pignon JP, Bourhis J, Domenge C, Designé L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three metaanalyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet 2000;355(9208):949-55.
5. Baujat B, Audry H, Bourhis J, Chan AT, Onat H, Chua DT, et al. Chemotherapy in locally advanced nasopharyngeal carcinoma: an individual patient data metaanalysis of eight randomized trials and 1753 patients. Int J Radiat Oncol Biol Phys 2006;64(1):47-56.
6. Al-Sarraf M, LeBlanc M, Giri PG, Fu KK, Cooper J, Vuong T, et al. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol 1998;16(4):1310-7.
7. Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB, et al. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 2004;350(19):1937-44.
8. Glynne-Jones R, Sebag-Montefiore D. Chemoradiation schedules-what radiotherapy? Eur J Cancer 2002;38(2):258-69.
9. Trotti A. Toxicity in head and neck cancer: a review of trends and issues. Int J Radiat Oncol Biol Phys 2000;47(1):1-12.
10. Available from: http://ctep.cancer.gov/forms/CTCv20 _4-30-992.pdf
11. LENT SOMA tables. Radiother Oncol 1995;35(1):17- 60.
12.Corvo R. Evidence-based radiation oncology in head and neck squamous cell carcinoma. Radiat Oncol 2007, in press.
13. Marcu L, van Doorn T, Olver I. Cisplatin and radiotherapy in the treatment of locally advanced head and neck cancer--a review of their cooperation. Acta Oncol 2003;42(4):315-25.
14. Al-Sarraf M. Treatment of locally advanced head and neck cancer: historical and critical review. Cancer Control 2002;9(5):387-99.
15.Bourhis J. New approaches to enhance chemotherapy in SCCHN. Ann Oncol. 2005;16 Suppl 6:vi20-vi24.
16.Cooper JS, Farnan NC, Asbell SO, Rotman M, Marcial V, Fu KK, et al. Recursive partitioning analysis of 2105 patients treated in Radiation Therapy Oncology Group studies of head and neck cancer. Cancer 1996;77(9):1905-11.
17. Withers HR, Taylor JM, Maciejewski B. The hazard of accelerated tumor clonogen repopulation during radiotherapy. Acta Oncol 1988;27(2):131-46.
18. Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, et al. Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol 2003;66(3):253-62.
19. Adelstein DJ, Li Y, Adams GL, Wagner H Jr, Kish JA, Ensley JF, et al. An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol 2003;21(1):92-8.
20. Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 2003;349(22):2091-8.
21. Serin M, Erkal HS, Cakmak A. Radiation therapy and concurrent cisplatin in management of locoregionally advanced nasopharyngeal carcinomas. Acta Oncol 1999;38(8):1031-5.
22.Jeremic B, Milicic B, Dagovic A, Vaskovic Z, Tadic L. Radiation therapy with or without concurrent lowdose daily chemotherapy in locally advanced, nonmetastatic squamous cell carcinoma of the head and neck. J Clin Oncol 2004;22(17):3540-8.
23. Lee AW, Lau WH, Tung SY, Chua DT, Chappell R, Xu L, et al. Preliminary results of a randomized study on therapeutic gain by concurrent chemotherapy for regionally-advanced nasopharyngeal carcinoma: NPC- 9901 Trial by the Hong Kong Nasopharyngeal Cancer Study Group. J Clin Oncol 2 0 0 5 ; 2 3 ( 2 8 ) : 6 9 6 6 - 7 5 .
24.Chan AT, Teo PM, Ngan RK, Leung TW, Lau W Zee B, et al. Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progressionfree survival analysis of a phase III randomized trial. J Clin Oncol 2002;20(8):2038-44.
25. Wee J, Tan EH, Tai BC, Wong HB, Leong SS, Tan T, et al. Randomized trial of radiotherapy versus concurrent chemoradiotherapy followed by adjuvant chemotherapy in patients with American Joint Committee on Cancer/International Union against cancer stage III and IV nasopharyngeal cancer of the endemic variety. J Clin Oncol 2005;23(27):6730-8.
26.Cheng SH, Tsai SY, Yen KL, Jian JJ, Chu NM, Chan KY, et al. Concomitant radiotherapy and chemotherapy for early-stage nasopharyngeal carcinoma. J Clin Oncol 2000;18(10):2040-5.
27. Mangar S, Slevin N, Mais K, Sykes A. Evaluating predictive factors for determining enteral nutrition in patients receiving radical radiotherapy for head and neck cancer: a retrospective review. Radiother Oncol 2006;78(2):152-8.
28.Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefèbvre JL, Greiner RH, et al. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 2004;350(19):1945-52.